Abstract
Background:
Yoga, a multicomponent mind–body practice, improves several domains of physical and psychological health and may affect frailty in older adults.
Purpose:
To evaluate the available trial evidence on the effect of yoga-based interventions on frailty in older adults.
Data Sources:
MEDLINE, EMBASE, and Cochrane Central from their inception to 12 December 2022.
Study Selection:
Randomized controlled trials evaluating the effect of yoga-based interventions, including at least 1 session of physical postures, on a validated frailty scale or single-item markers of frailty in adults aged 65 years or older.
Data Extraction:
Two authors independently screened articles and extracted data; 1 author assessed risk of bias with review from a second author. Disagreements were resolved through consensus and as-needed input from a third author.
Data Synthesis:
Thirty-three studies (n = 2384 participants) were identified in varied populations, including community dwellers, nursing home residents, and those with chronic disease. Yoga styles were primarily based on Hatha yoga and most often included Iyengar or chair-based methods. Single-item frailty markers included measures of gait speed, handgrip strength, balance, lower-extremity strength and endurance, and multicomponent physical performance measures; no studies included a validated definition of frailty. When compared with education or inactive control, there was moderate-certainty evidence that yoga improved gait speed and lower-extremity strength and endurance, low-certainty evidence for balance and multicomponent physical function measures, and very low-certainty evidence for handgrip strength.
Limitation:
Heterogeneity in study design and yoga style, small sample sizes, and reporting deficiencies leading to concerns for selection bias.
Conclusion:
Yoga may affect frailty markers that are associated with clinically meaningful outcomes in older adult populations but may not offer benefit over active interventions (for example, exercise).
Primary Funding Source:
None. (PROSPERO: CRD42020130303)
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Author, Article, and Disclosure Information
Authors:
Julia Loewenthal,
Division of Aging, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts (J.L.)
Department of Epidemiology, West Virginia University School of Public Health, Morgantown, West Virginia (K.E.I.)
Renaissance School of Medicine at Stony Brook University, Stony Brook, New York (M.M.)
Countway Library, Harvard Medical School, Boston, Massachusetts (C.M.)
Division of Aging, Brigham and Women's Hospital, Harvard Medical School, and New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts (A.R.O.).
Note: An earlier version of this work was presented as a poster at the American Geriatrics Society Annual Scientific Meeting, virtual, in May 2021.
Acknowledgment: This work is dedicated to the memory of William Shrauner, MD. The authors acknowledge the contributions of Racheli Schoenberg, MD.
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-2553.
Reproducible Research Statement: Study protocol: Available in the Supplement and from Dr. Loewenthal (e-mail, jloewenthal@bwh.
Corresponding Author: Julia Loewenthal, MD, Division of Aging, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115; e-mail, jloewenthal@bwh.
Author Contributions: Conception and design: K.E. Innes, J. Loewenthal, A.R. Orkaby.
Analysis and interpretation of the data: K.E. Innes, J. Loewenthal, A.R. Orkaby.
Drafting of the article: K.E. Innes, J. Loewenthal, C. Mita, M. Mitzner, A.R. Orkaby.
Critical revision of the article for important intellectual content: K.E. Innes, J. Loewenthal, A.R. Orkaby.
Final approval of the article: K.E. Innes, J. Loewenthal, C. Mita, M. Mitzner, A.R. Orkaby.
Administrative, technical, or logistic support: A.R. Orkaby.
Collection and assembly of data: J. Loewenthal, C. Mita, M. Mitzner, A.R. Orkaby.
This article was published at Annals.org on 14 March 2023.
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